Urinary Incontinence [antikvár]

INTRODUCTION Studies published to date concerning the epidemiology of urinary incontinence are very disparate. Sample sizes, age-groups studied, the modalities of data collection (postai questionnaires, direct interviews, questioning of the patients, their relatives and friends or health professionals) and especially the type of questions asked, are very variable. Prevalence surveys, based on the probability of being incontinent in a given community, are far more frequent than incidence studies, which are designed to predict the probability of becoming incontinent over a given period. Furthermore, epidemiological surveys are particularly concerned with the urinary incontinence itself or its psychological and social consequences, or both. It is difficult, therefore, to design a coherent medical, social and economic management policy for urinary incontinence on the basis of reliable, valid, reproducible and comparable epidemiological data. These difiiculties are primarily due to differences in definitions and concepts. DEFINITION AND CONCEPTS According to the International Continence Society definition, urinary incontinence is 'a condition in which the involuntary loss of urine constitutes a social or hygiene problem and can be objectively demonstrated' (Bates et al 1979). This standardized definition was published in 1979, but has not always been adopted in subsequent epidemiological studies (Vellas et al 1989). However, this definition has little practical value for epidemiological studies, as the acceptability of genuine incontinence varies considerably between cultures and countries and according to lifestyle and age-group. These variations explain somé of the underestimations by subjects. They may consider urinary incontinence to be commonplace or inevitable and not warrant mentioning or reporting; they may suffer psychologically from their problem and not want their incontinence to be revealed. Conversely, certain individual psychological structures tend to overestimate this phenomenon, in the absence of any objectively demonstrable incontinence.